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coma vigile
Dear sir.

Question si about my father who suffered anoxic brain injury after the cardiac arrest. He is in Coma 4 months at the moment. In the meantime, we were working very hard to change anything. Our first step was the transport to Zagreb at Hospital «Dubrava» at the department of neurosurgery. When we came there, my father was with GCS 4, with no any reflex of muslces, or any other reaction on pain stimulation. His view when he is awake was fixed with no any movement of eyes. His EEG at Sarajevo's Hospital was without any beta waves. At «Dubrava» doctors made some tests and search such as PET-CT, Multimode evoked potentials, and 24hours of EEG. After the analysis, they've told us that for their opinion my father is an candidate for Deep brain stimulation. 24 hours EEG showed that he's got beta waves two times – at 02:00 o'clock in the morning and also 09:00 o'clock in the morning.Multimode evoked potentials have showed that al motor cortex responses and sensors are OK (no damage), and only problem for my father if he sometimes regain consciousness acording to Multimode evoked potentials could be with his legs, because doctor neurophysiologist, didn't get respons from legs. PET –CT showed some reduced metabolism in the thalamus, and some hyper metabolism  in the parietal part of the brain. After the analysis of the results, we gave our permision to doctor  and neurosurgeon to implant the electrode in the parafascicular part of the thalamus and since that we are stimulating our father every day 6 times by day. Opinion of the doctors is that my father has a chance, but he'll need more time (Doctor thinks that he'll not give any concrete result till the September).At the moment, It's 44. day of stimulation. We are doing that every day 6-times by day.My father have some special food for eat (more proteins, and carbohydrates). As we can see till today, he is much closer to us, his wiev is not just focused, he is moving eyes, and in some cases we think that he looked us. He regaind reaction on pain stimulans, he has motor reflexes of every leg and arm muscles, and he looks as just he is defending from the pain when for example Physiotherapist works with him or when we withdraw his hair or similar things. Also, when we ask him to squeeze the hand, he do It, but not every time. At two times , he had also closed his eyes on our asking. He is making sometimes some strange facial expressions and  two times he moved his head. At the moment, he hasn't any infection, everything is clear thank God for that. Of course, doctors here in Sarajevo also done an EEG 5 days ago, and they've told us: «acording to this EEG your father possibly isn't in the vegetative state»-doctor said that he is moving up. He told us that he's got alpha and beta waves for just 7 minutes of recording of EEG. I must tell you that now he's got beta waves in the different time of day when you compare that with 24 hours EEG that he maked in Zagreb (now he has got the beta waves at 10:40 in the morning – when they've done that EEG exactlly).

I have a few questions for you, so please dr., can you answer me on?

What is your opinion about this Deep Brain Stimulation? Evident is that my father has some changes after we implanted the electrode in the thalamus. Do you know the similar cases that implanted the stimulation electrode in the thalamus?

Do you have any experience with this Deep brain stimulation for the people in the Vegetative State?

What you can propose to me in this moment, is there anything more to do and what? Is the time only that I must wait for? Is there any good rehabilitation for him that can with this deep brain stimulation push him more up to awareness?

Next question is very important for me:

Have you heard about this medicines – «Zolpidem», «Levodopa» and „Amantadine“ for the people in the Vegetative state and what do you think about them? Is there any chance to find It somewhere in Europe and for your opinion is there a posibillity that they can help my father?

With best regards,

Sincerly yours,

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